Background:The gender,age,alpha-fetoprotein(AFP),and des-gamma-carboxy prothrombin(GAAD)score is a recent predictive tool for hepatocellular carcinoma(HCC)but lacks comparison with the AFP,Sex,Age,and Protein induced ...Background:The gender,age,alpha-fetoprotein(AFP),and des-gamma-carboxy prothrombin(GAAD)score is a recent predictive tool for hepatocellular carcinoma(HCC)but lacks comparison with the AFP,Sex,Age,and Protein induced by vitamin K absence-II(ASAP)score,which uses similar parameters with different assays and formulas.Our study aimed to evaluate the performance differences between these two scores.Methods:Blood samples from 622 patients with chronic liver diseases at Songklanagarind Hospital between 20 April 2023 and 31 December 2023 were analyzed.The cutoffs for the ASAP and GAAD scores were established as 0.526 and 2.570,respectively,and HCC diagnoses followed the European Association for the Study of the Liver(EASL)or the American Association for the Study of Liver Diseases(AASLD)guidelines.Results:HCC diagnoses were observed in 28.6%of patients,with 48.3%diagnosed with early-stage diseases(Barcelona Clinic Liver Cancer stage 0=23,A=63).Hepatitis B virus infection(40.4%)and metabolic dysfunction-associated steatotic liver disease(21.3%)were predominant causes.The area under the receiver operating characteristic curve(AUROCs)of the ASAP and GAAD scores for predicting all-stage HCC were comparable(0.933 vs 0.937,P=0.578).For early-stage HCC,AUROCs were 0.880(ASAP)and 0.891(GAAD)(P=0.353).Sensitivity and specificity for predicting all-stage HCC were 83.15%and 91.44%(ASAP),and 82.58%and 89.64%(GAAD),respectively;these values for early-stage HCC were 66.28%and 91.44%(ASAP)and 67.44%and 89.64%(GAAD).Subgroup analyses by cirrhosis and etiology showed no significant differences.New cutoff values of−0.083(ASAP)and 1.725(GAAD)were identified for at least 80%sensitivity and specificity for predicting early-stage HCC.Conclusion:Both the GAAD and ASAP scores demonstrated excellent and comparable abilities in HCC detection across all stages,unaffected by cirrhosis or etiological differences.展开更多
Background and Aims:Early detection of hepatocellular carcinoma(HCC)is crucial for improving survival in patients with chronic hepatitis.The GALAD algorithm combines gen-der(biological sex),age,α-fetoprotein(AFP),Len...Background and Aims:Early detection of hepatocellular carcinoma(HCC)is crucial for improving survival in patients with chronic hepatitis.The GALAD algorithm combines gen-der(biological sex),age,α-fetoprotein(AFP),Lens culinaris agglutinin-reactive fraction of AFP(AFP-L3),and protein in-duced by vitamin K absence or antagonist-II(PIVKA-II)for HCC detection.Similarly,the GAAD algorithm incorporates gender(biological sex),age,AFP,and PIVKA-II.This study aimed to assess the clinical utility of AFP-L3 in the GALAD algorithm and its potential synergies with ultrasound.We compared the clinical performance of GALAD with GAAD;AFP;AFP-L3;and PIVKA-II,with or without ultrasound,in Taiwan residents adults.Methods:A total of 439 serum samples were analyzed using a Cobas®e 601 analyzer(healthy con-trols,n=200;chronic liver disease controls,n=177;HCC cases,n=62).Performance was assessed through receiver operating characteristic curve analyses to calculate the area under the curve.Results:The area under the curve for dif-ferentiating early-stage HCC from patients with chronic liver disease was optimal for PIVKA-II(84.9%),GAAD(79.8%),and GALAD(79.4%),with slightly improved performance for detecting all-stage HCC.Clinical performance was unaffected by disease stage or etiology.Sensitivity for early-stage HCC was highest for GAAD(57.6%)and GALAD(57.6%).Sen-sitivity for each strategy was further enhanced when com-bined with ultrasound,regardless of disease stage or etiology(P<0.01).Conclusions:These findings indicate that the role of AFP-L3 in the GALAD algorithm is minimal,supporting the use of GAAD for HCC detection.A combination of GAAD,GALAD,or PIVKA-II with ultrasound may improve diagnostic efficiency compared with recommended strategies.展开更多
基金funded by the Faculty of Medicine,Prince of Songkla University,Songkhla,Thailand and the Gastroenterological Association of Thailand(GAT).
文摘Background:The gender,age,alpha-fetoprotein(AFP),and des-gamma-carboxy prothrombin(GAAD)score is a recent predictive tool for hepatocellular carcinoma(HCC)but lacks comparison with the AFP,Sex,Age,and Protein induced by vitamin K absence-II(ASAP)score,which uses similar parameters with different assays and formulas.Our study aimed to evaluate the performance differences between these two scores.Methods:Blood samples from 622 patients with chronic liver diseases at Songklanagarind Hospital between 20 April 2023 and 31 December 2023 were analyzed.The cutoffs for the ASAP and GAAD scores were established as 0.526 and 2.570,respectively,and HCC diagnoses followed the European Association for the Study of the Liver(EASL)or the American Association for the Study of Liver Diseases(AASLD)guidelines.Results:HCC diagnoses were observed in 28.6%of patients,with 48.3%diagnosed with early-stage diseases(Barcelona Clinic Liver Cancer stage 0=23,A=63).Hepatitis B virus infection(40.4%)and metabolic dysfunction-associated steatotic liver disease(21.3%)were predominant causes.The area under the receiver operating characteristic curve(AUROCs)of the ASAP and GAAD scores for predicting all-stage HCC were comparable(0.933 vs 0.937,P=0.578).For early-stage HCC,AUROCs were 0.880(ASAP)and 0.891(GAAD)(P=0.353).Sensitivity and specificity for predicting all-stage HCC were 83.15%and 91.44%(ASAP),and 82.58%and 89.64%(GAAD),respectively;these values for early-stage HCC were 66.28%and 91.44%(ASAP)and 67.44%and 89.64%(GAAD).Subgroup analyses by cirrhosis and etiology showed no significant differences.New cutoff values of−0.083(ASAP)and 1.725(GAAD)were identified for at least 80%sensitivity and specificity for predicting early-stage HCC.Conclusion:Both the GAAD and ASAP scores demonstrated excellent and comparable abilities in HCC detection across all stages,unaffected by cirrhosis or etiological differences.
基金funded by Roche Diagnostics GmbH and partly supported by the“Center of Excellence for Metabolic Associated Fatty Liver Disease,National Sun Yat-sen University,Kaohsiung”,under The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education in Taiwan.
文摘Background and Aims:Early detection of hepatocellular carcinoma(HCC)is crucial for improving survival in patients with chronic hepatitis.The GALAD algorithm combines gen-der(biological sex),age,α-fetoprotein(AFP),Lens culinaris agglutinin-reactive fraction of AFP(AFP-L3),and protein in-duced by vitamin K absence or antagonist-II(PIVKA-II)for HCC detection.Similarly,the GAAD algorithm incorporates gender(biological sex),age,AFP,and PIVKA-II.This study aimed to assess the clinical utility of AFP-L3 in the GALAD algorithm and its potential synergies with ultrasound.We compared the clinical performance of GALAD with GAAD;AFP;AFP-L3;and PIVKA-II,with or without ultrasound,in Taiwan residents adults.Methods:A total of 439 serum samples were analyzed using a Cobas®e 601 analyzer(healthy con-trols,n=200;chronic liver disease controls,n=177;HCC cases,n=62).Performance was assessed through receiver operating characteristic curve analyses to calculate the area under the curve.Results:The area under the curve for dif-ferentiating early-stage HCC from patients with chronic liver disease was optimal for PIVKA-II(84.9%),GAAD(79.8%),and GALAD(79.4%),with slightly improved performance for detecting all-stage HCC.Clinical performance was unaffected by disease stage or etiology.Sensitivity for early-stage HCC was highest for GAAD(57.6%)and GALAD(57.6%).Sen-sitivity for each strategy was further enhanced when com-bined with ultrasound,regardless of disease stage or etiology(P<0.01).Conclusions:These findings indicate that the role of AFP-L3 in the GALAD algorithm is minimal,supporting the use of GAAD for HCC detection.A combination of GAAD,GALAD,or PIVKA-II with ultrasound may improve diagnostic efficiency compared with recommended strategies.
